Juvenile idiopathic arthritis in two tertiary centres in the Western Cape, South Africa
Date
2012-10
Authors
Weakley, Kate
Esser, Monika
Scott, Christiaan
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
BACKGROUND: Juvenile idiopathic arthritis (JIA) is a disease that shows wide variations between differing
populations. Since the recent international consensus on classification criteria, JIA has been widely described in
many countries and population groups. There has been almost no data that describes JIA in an African, specifically
Sub-Saharan African, setting. Therefore, the aim of this study is to describe disease characteristics, disease course,
and functional disability in two tertiary centres in the Western Cape, South Africa and compare the findings to
other JIA populations.
Methods: Eighty-six children were recruited during random clinic visits to rheumatology clinics at Tygerberg and
Groote Schuur Hospital between April 2010 and April 2011. Children were diagnosed using International League of
Associations for Rheumatology (ILAR) 2001 classification criteria. Consent was obtained and medical records
examined. The Childhood Health Assessment Questionnaires (CHAQ) and visual analogue scales (VAS) for pain and
general well-being were completed and all children were examined by a researcher in conjunction with a
paediatric rheumatologist. HIV status as well as tuberculosis disease and treatment were investigated.
Results: A total of 86 children were enrolled. Eight children were excluded (2 HIV arthropathy, 1 TB arthritis, 1 SLE,
4 with insufficient data), leaving a total of 78 patients. There was an equal female to male ratio-39 males and 39
females. There were 6 systemic JIA patients (7.69%), 17 persistent oligoarthritis (21.79%), 4 extended oligoarthritis
(5.12%), 11 polyarthritis rheumatoid factor (RF) positive (14.10%), 21 polyarthritis RF negative (26.9%), 1 psoriatic
arthritis (1.28%), and 18 enthesitis-related arthritis (23%). The median CHAQ for the group was 0.5 (IQR 0.1-1.25),
the median VAS for pain was 18 mm (IQR 4–42) and median VAS for general well-being was 25 mm (IQR 3–49).
Enthesitis-related arthritis and polyarthritis disease subtypes in this South African population may be more common
than seen in JIA populations described in northern Europe, India, United Kingdom, and Turkey.
Conclusion: This Western Cape South African JIA population appears to have a different profile of JIA than what
has been described elsewhere. Enthesitis-related arthritis and polyarthritis disease subtypes appear to be more
prevalent. There are also significant challenges in this setting such as later presentation to pediatric
rheumatologists, different disease characteristics, and variable disease courses.
Description
The original publication is available at http://www.ped-rheum.com/content/10/1/35
Bibliography
Bibliography
Keywords
Juvenile idiopatheic arthritis -- Functional disability, Juvenile rheumatoid arthritis -- Diagnosis -- South Africa -- Western Cape, Juvenile idiopatheic arthritis -- Treatment -- South Africa -- Western Cape
Citation
Weakley, K., Esser, M. & Scott, C. 2012. Juvenile idiopathic arthritis in two tertiary centres in the Western Cape, South Africa. Pediatric Rheumatology, 10(1):35, doi.org/10.1186/1546-0096-10-35.